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The Coder III Specialist- Professional Specialty Services- Procedural reviews electronic medical record documentation, and applies ICD and CPT codes, per Official Coding Guidelines, with a specific focus on office visit and/or minor surgical procedures. This position abstracts key data elements necessary for billing and data analysis.
WHO WE ARE
With 11 ministries and access points across Indiana, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
Data Analysis- Professional Coding Reviews and analyzes the content of the medical record to determine when documentation should be utilized for appropriate assignment of ICD diagnosis codes, CPT repetitive or non-invasive procedure codes, modifiers, hierarchical condition categories, complications, and comorbidities to meet coding guidelines.
Data Analysis- Professional Coding Accurately reviews and codes patient records in the following clinical areas: professional office visits and/or minor surgical procedures.
Data Interpretation- Professional Coding Evaluates appropriateness of diagnosis and procedure codes and modifiers utilized in response to Outpatient Code Editor and National Correct Coding Initiative edits.
Clinical Documentation Analysis Reviews clinical documentation to validate accurate representation of the patient's clinical picture, treatment, and diagnoses. Identifies when documentation relevant to the coding process is missing, lacks specificity or is inconsistent and take steps to obtain the documentation.
Abstracting Data Identifies and enters data elements for abstracting.
Coding Accuracy Meets defined coding accuracy standards
Coding Productivity Meets defined coding productivity standards
Subject Matter Expert- Coding Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability.
Subject Matter Expert- Coding Understands how diagnosis and procedure codes, and reimbursement methodologies are used to determine reimbursement, public reporting of outcomes, quality of patient care, financial modeling, strategic planning, and marketing.
Subject Matter Expert- Coding Remains current with coding and industry changes through participation in educational opportunities.
Subject Matter Expert- Professional Coding Demonstrates a thorough knowledge of professional coding guidelines, medical terminology, anatomy/physiology, and payer specific coding guidelines
Process Improvement Notifies coding leadership of trends and topics for education and feedback to physicians and departments.
Process Improvement Assists with identification and implementation of process improvements according to industry best practice standards to make the best use of resources, decrease costs and improve coding services across the specialized service lines.
Ethics Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.
QUALIFICATIONS
High School Diploma/GED - Required
Associate or Bachelor's Degree - Preferred
1 Year Coding - Required
CCS, CCS-P, or CPC - Required
RHIT/RHIA - Preferred
TRAVEL IS REQUIRED:
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
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